Sports Health-A Multidisciplinary Approach最新文献

{"title":"Subjective Causes for Failure to Return to Sport After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.","authors":"Katie Yensen, Cory K Mayfield, Ioanna K Bolia, Ryan A Palmer, Michael Brown, Daniel R Kim, Maya S Abu-Zahra, Jacob L Kotlier, Thomas Webb, Emmett Cleary, Nima Saboori, Frank A Petrigliano, Alexander E Weber","doi":"10.1177/19417381241231631","DOIUrl":"10.1177/19417381241231631","url":null,"abstract":"<p><strong>Context: </strong>While current literature has explored the outcomes of athletes who return to sport (RTS) after anterior cruciate ligament (ACL) injuries, less is known about the outcomes of those who are unsuccessful in returning to sport.</p><p><strong>Objective: </strong>To determine the rate of athletes who did not RTS after primary ACL reconstruction (ACLR) and to identify the specific subjective reasons for failure to RTS.</p><p><strong>Data sources: </strong>A comprehensive search of the PubMed/MEDLINE, Scopus, and Web of Science databases was conducted through April 2021.</p><p><strong>Study selection: </strong>Eligible studies included those explicitly reporting the rate of failure for RTS after ACLR as well as providing details on reasons for athletes' inability to return; 31 studies met the inclusion criteria.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Level of evidence: </strong>Level 2 to 4.</p><p><strong>Data extraction: </strong>The reasons for failure to RTS referred to in our study are derived from those established previously in the studies included. Data were collected on the number of athletes, mean age, mean follow-up time, type of sport played, failure to RTS rate, and specific reasons for failure to return.</p><p><strong>Results: </strong>The weighted rate of failure to RTS after ACLR was 25.5% (95% CI, 19.88-31.66). The estimated proportion of psychosocial-related reasons cited for failure to RTS was significantly greater than knee-related reasons for failure RTS (55.4% vs 44.6%, <i>P</i> < 0.01). The most cited reason for failure to RTS was fear of reinjury (33.0%).</p><p><strong>Conclusion: </strong>This study estimates the rate of failure to RTS after ACLR to be 25.5%, with the majority of athletes citing fear of reinjury as the major deterrent for returning to sports. We highlight how factors independent of surgical outcomes may impact an athlete's ability to return to play given that the predominant reason for no RTS after ACLR was unrelated to the knee.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"243-251"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Customized Landing Task for ACL Injury Risk Assessment: Kinematic Sex-Related Differences.","authors":"Claudia Brunetti, Rodrigo Rabello, Federico Adragna, Lucas Silva Zandonato, Alessandro Zucchetti, Filippo Bertozzi, Manuela Galli, Chiarella Sforza","doi":"10.1177/19417381241236893","DOIUrl":"10.1177/19417381241236893","url":null,"abstract":"<p><strong>Background: </strong>Women present a higher anterior cruciate ligament (ACL) injury rate than men, suggesting sex-related biomechanical differences. Task characteristics are often fixed for both sexes, possibly affecting the perceived difficulty. We investigated kinematic sex differences across landing tasks for ACL injury risk assessment, adjusted to participants' anthropometrics/performance, and whether different tasks affect kinematic sex comparisons.</p><p><strong>Hypothesis: </strong>Female subjects would exhibit motion patterns more associated with ACL injury risk, and sex-related differences may depend on task type.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 27 female and 29 male amateur players (18-30 years) executed horizontal hop, drop jump (DJ), and DJ followed by vertical or forward jump (length, proportional to maximal forward jump; box, 20% participant's height). An optoelectronic system provided lower limb kinematics at initial contact and peaks until maximum knee flexion (KF), analyzed separately by multivariate analysis of variance (MANOVA) (α = 0.05).</p><p><strong>Results: </strong>At initial contact, the interaction term had significant effects on hip adduction (<i>P</i> < 0.01) and knee abduction (KAb) (<i>P</i> = 0.04); female participants demonstrated higher KAb (<i>P</i> < 0.01) and knee internal rotation (<i>P</i> = 0.05). For peaks analysis, the interaction term had no significant effects on any individual variable, although significant in MANOVA; female participants had higher KAb (<i>P</i> = 0.01) and lower KF (<i>P</i> = 0.04). Task type affected hip flexion and knee angles in both analyses.</p><p><strong>Conclusion: </strong>All variables in which significant sex-related differences were found are potential ACL injury risk factors, and all findings indicate that the analyzed female sample exhibited higher injury-related patterns. Although customized, male and female participants showed different landing strategies depending on the task.</p><p><strong>Clinical relevance: </strong>The findings underline how female participants adopted potentially harmful kinematics while executing customized landing tasks (adjusted by subject's anthropometrics/performance), which may enhance risk of ACL injury.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"252-261"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Lifting Straps on the Relationship Between Maximum Repetitions to Failure and Lifting Velocity During the Prone Bench Pull Exercise.","authors":"Sergio Miras-Moreno, Amador García-Ramos, Francisco J Rojas-Ruiz, Alejandro Pérez-Castilla","doi":"10.1177/19417381241235163","DOIUrl":"10.1177/19417381241235163","url":null,"abstract":"<p><strong>Background: </strong>Fastest mean (MV_fastest) and peak (PV_fastest) velocity of the set have been proposed to predict the maximum number of repetitions to failure (RTF) during the Smith machine prone bench pull (PBP) exercise.</p><p><strong>Hypothesis: </strong>Goodness-of-fit would be higher for individualized compared with generalized RTF-velocity relationships and comparable for both execution equipment conditions (with or without straps), and the MV_fastest and PV_fastest associated with each RTF would be comparable between execution equipment and prediction methods (multiple- vs 2-point method).</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>After determining the PBP 1-repetition maximum (1RM), 20 resistance-trained male athletes performed 2 sessions randomly, with and without lifting straps, consisting of single sets to failure against the same load sequence (60% to 80% to 70% 1RM). Generalized (pooling data from all subjects) and individualized (separately for each subject using multiple-point or 2-point methods) RTF-velocity relationships were constructed.</p><p><strong>Results: </strong>Individualized RTF-velocity relationships were always stronger than generalized RFT-velocity relationships, but comparable with (MV_fastest: <i>r</i>² = 0.87-0.99]; PV_fastest: <i>r</i>² = 0.88-1.00]) and without (MV_fastest: <i>r</i>² = 0.82-1.00; PV_fastest: <i>r</i>² = 0.89-0.99]) lifting straps. The velocity values associated with each RTF were comparable between execution equipment (<i>P</i> ≥ 0.22), but higher for the multiple-point compared with the 2-point method (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>The use of lifting straps during the Smith machine PBP exercise does not affect the goodness-of-fit of the RTF-velocity relationships or the velocity values associated with different RTFs. However, caution should be exercised when using different methods.</p><p><strong>Clinical relevance: </strong>The benefits of the RTF-velocity relationships can be extrapolated when using lifting straps, and the 2-point method can also be used as a quick and more fatigue-free procedure. Nevertheless, it is imperative for coaches to ensure that these relationships are reflective of fatigue experienced during training.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"332-341"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Heat Acclimatization, Heat Acclimation, and Intermittent Heat Training on Maximal Oxygen Uptake.","authors":"Ryan A Dunn, Lauren A Fry, Yasuki Sekiguchi, Courteney L Benjamin, Ciara N Manning, Robert A Huggins, Rebecca L Stearns, Douglas J Casa","doi":"10.1177/19417381241249470","DOIUrl":"10.1177/19417381241249470","url":null,"abstract":"<p><strong>Background: </strong>Maximal oxygen uptake (VO_2max) is an important determinant of endurance performance. Heat acclimation/acclimatization (HA/HAz) elicits improvements in endurance performance. Upon heat exposure reduction, intermittent heat training (IHT) may alleviate HA/HAz adaptation decay; however, corresponding VO_2max responses are unknown.</p><p><strong>Hypothesis: </strong>VO_2max is maintained after HAz/HA; IHT mitigates decrements in aerobic power after HAz/HA.</p><p><strong>Study design: </strong>Interventional study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 27 male endurance runners (mean ± SD; age, 36 ± 12 years; body mass, 73.03 ± 8.97 kg; height, 178.81 ± 6.39 cm) completed VO_2max testing at 5 timepoints; baseline, post-HAz, post-HA, and weeks 4 and 8 of IHT (IHT₄, IHT₈). After baseline testing, participants completed HAz, preceded by 5 days of HA involving exercise to induce hyperthermia for 60 minutes in the heat (ambient temperature, 39.13 ± 1.37°C; relative humidity, 51.08 ± 8.42%). Participants were assigned randomly to 1 of 3 IHT groups: once-weekly, twice-weekly, or no IHT. Differences in VO_2max, velocity at VO_2max (vVO₂), and maximal heart rate (HR_max) at all 5 timepoints were analyzed using repeated-measure analyses of variance with Bonferroni corrections post hoc.</p><p><strong>Results: </strong>No significant VO_2max or vVO₂ differences were observed between baseline, post-HAz, or post-HA (<i>P</i> = 0.36 and <i>P</i> = 0.09, respectively). No significant group or time effects were identified for VO_2max or vVO₂ at post-HA, IHT₄, and IHT₈ (<i>P</i> = 0.67 and <i>P</i> = 0.21, respectively). Significant HR_max differences were observed between baseline and post-HA tests (<i>P</i> < 0.01). No significant group or time HR_max differences shown for post-HA, IHT₄, and IHT₈ (<i>P</i> = 0.59).</p><p><strong>Conclusion: </strong>VO_2max was not reduced among endurance runners after HA/HAz and IHT potentially due to participants' similar aerobic training status and high aerobic fitness levels.</p><p><strong>Clinical relevance: </strong>HAz/HA and IHT maintain aerobic power in endurance runners, with HAz/HA procuring reductions in HR_max.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"305-311"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Does Physical and Psychological Recovery Vary Among Competitive and Recreational Athletes After Anterior Cruciate Ligament Reconstruction?","authors":"Mandeep Kaur, Terese L Chmielewski, Susan Saliba, Joe Hart","doi":"10.1177/19417381241249413","DOIUrl":"10.1177/19417381241249413","url":null,"abstract":"<p><strong>Background: </strong>The recovery and rehabilitation journey after anterior cruciate ligament reconstruction (ACLR) surgery can be different for competitive and recreational athletes as their motivation and goals toward sports are different.</p><p><strong>Hypothesis: </strong>Competitive athletes would present with better patient-reported outcomes and higher muscle strength compared with recreational athletes postsurgery. Second, competitive athletes would recover better (patient-reported outcome [PRO] measures and muscle strength) compared with recreational athletes at later stages.</p><p><strong>Study design: </strong>Cross-sectional laboratory-based study.</p><p><strong>Level of evidence: </strong>Level 2.</p><p><strong>Methods: </strong>A total of 245 patients with unilateral ACLR were categorized as competitive or recreational athletes and grouped into early (4-6.9 months) or late (7-10 months) stages of recovery. PRO were collected for psychological response (Tampa Scale Kinesiophobia; Anterior Cruciate Ligament-Return to Sport after Injury), perceived knee function (International Knee Documentation Committee subjective form [IKDC]), and quality of life (Knee injury and Osteoarthritis Outcome Score; Veteran Rand-12). Isokinetic, concentric knee extension strength was measured bilaterally with a multimodal dynamometer (System 4, Biodex Medical Systems) at a speed of 90° and 180°/s.</p><p><strong>Results: </strong>Competitive athletes had significantly higher scores for IKDC (<i>P</i> = 0.03), and quadriceps peak torque at 90°/s (<i>P</i> = 0.01) and 180°/s (<i>P</i> < 0.01) compared with recreational athletes. Competitive athletes had higher quadriceps strength at 90°/s (<i>P</i> < 0.01) and 180°/s (<i>P</i> = 0.02) in the late group. Recreational athletes displayed higher sports participation in the late group.</p><p><strong>Conclusion: </strong>Outcomes of ACLR may differ based on preinjury athletic level. Whereas competitive athletes had higher knee and muscle function than recreational athletes, psychological measures were not different among groups.</p><p><strong>Clinical relevance: </strong>There is a need for more individualized care for patients with ACLR since there is variability among patient goals postsurgery. This information might help set realistic expectations for competitive and recreational athletes after surgery.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"272-280"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Therapy Intervention Effects on Alteration of Spinal Excitability in Patients With Chronic Ankle Instability: A Systematic Review and Meta-analysis.","authors":"Chia-Wei Lin, Amornthep Jankaew, Cheng-Feng Lin","doi":"10.1177/19417381241253248","DOIUrl":"10.1177/19417381241253248","url":null,"abstract":"<p><strong>Context: </strong>Chronic ankle instability (CAI) is a common injury in athletes. Different forms of physical therapy have been applied to the population with CAI to assess their impact on spinal excitability.</p><p><strong>Objective: </strong>The purpose of this systematic review and meta-analysis was to investigate the effectiveness of various physical therapy interventions on the alteration of spinal excitability in patients with CAI.</p><p><strong>Data sources: </strong>Four databases (EMBASE, MEDLINE, Cochrane CENTRAL, and Scopus) were searched from inception to November 2022.</p><p><strong>Study selection: </strong>A total of 253 studies were obtained and screened; 11 studies on the effects of physical therapy intervention on the alteration of spinal excitability in patients with CAI were identified for meta-analysis.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Level of evidence: </strong>Level 3a.</p><p><strong>Data extraction: </strong>A total of 11 studies that included the maximal Hoffmann reflex normalized by the maximal muscle response (H/M ratio) in the peroneus longus and soleus muscles were extracted and summarized. The quality of the studies was assessed using the PEDro scale.</p><p><strong>Results: </strong>The extracted studies had an average PEDro score of 4.7 ± 1.4, indicating that most of them had fair-to-good quality. The physical therapy interventions included cryotherapy, taping, mobilization, proprioceptive training, and dry needling. The overall effects showed that the H/M ratios of the peroneus longus (<i>P</i> = 0.44, <i>I</i>² = 0%) and soleus (<i>P</i> = 0.56,<i>I</i>² = 22%) muscles were not changed by physical therapy in patients with CAI.</p><p><strong>Conclusion: </strong>The meta-analysis indicated that physical therapy interventions such as cryotherapy, taping, mobilization, proprioceptive training, and dry needling do not alter the spinal excitability in patients with CAI. Given that only 1 study reported ineffective changes in spinal excitability with dry needling, more research is essential to establish and validate its efficacy.</p><p><strong>Prospero registration: </strong>CRD42022372998.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"394-403"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Hormone Profiles and ACL Injury - It's Time for Study Designs to Match the Complexity of the Problem.","authors":"Sandra J Shultz, Laurie Wideman","doi":"10.1177/19417381251319506","DOIUrl":"10.1177/19417381251319506","url":null,"abstract":"","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":"17 2","pages":"223-225"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Factors Are Related to Neuromuscular Asymmetries After Anterior Cruciate Ligament Reconstruction.","authors":"Joanna Borawski, Richard Arthur Brindle, Erin Florkiewicz, John S Mason, Will Pitt, Kenneth L Cameron, Michael S Crowell","doi":"10.1177/19417381241246754","DOIUrl":"10.1177/19417381241246754","url":null,"abstract":"<p><strong>Background: </strong>After an anterior cruciate ligament reconstruction (ACLR), only 47% of military members return to full duty, possibly due to persistent neuromuscular asymmetries. Psychological factors may also contribute to reduced return to duty in military members.</p><p><strong>Hypothesis: </strong>Psychological factors and time since surgery would be associated negatively with neuromuscular asymmetries, asymmetries would be greater in cadets postsurgery when compared with healthy controls, and asymmetries would be greater at earlier timepoints after ACLR.</p><p><strong>Study design: </strong>Case control.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Methods: </strong>This study examined the relationship between psychological factors and time since surgery with neuromuscular asymmetry, compared neuromuscular asymmetries between cadets with and without a history of ACLR, and explored differences in neuromuscular asymmetries at different timepoints in cadets with a history of ACLR. A total of 37 cadets post-ACLR (18.3 ± 9 months) and 28 controls participated. Psychological factors were assessed using the Tampa Scale of Kinesiophobia and Anterior Cruciate Ligament-Return to Sport after Injury scale (ACL-RSI). Participants performed a drop-jump landing, joint positioning sense (JPS), and isometric quadriceps strength testing. Peak vertical ground-reaction forces (vGRF), absolute angle of replication, peak quadriceps torque, rate of torque development (RTD), and RTD time torque interval 200 ms (TTI₂₀₀) were analyzed.</p><p><strong>Results: </strong>The ACL-RSI score was significantly related to limb symmetry index (LSI) peak quadriceps torque (<i>r</i> = 0.617, <i>P</i> < 0.01), LSI RTD (r = 0.367, <i>P</i> = 0.05), and LSI TTI₂₀₀ (r = 0.0489, <i>P</i> < 0.01), but not time since surgery, JPS, or LSI peak vGRF. Cadets with a history of ACLR had significantly lesser ACL-RSI scores and greater asymmetries compared with controls.</p><p><strong>Conclusion: </strong>Reduced psychological readiness was associated with increased neuromuscular asymmetries after ACLR.</p><p><strong>Clinical relevance: </strong>Clinicians should assess psychological readiness during rehabilitation after ACLR.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"262-271"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Eccentric Versus Concentric Strengthening in Patients With Subacromial Pain Syndrome: A Randomized Controlled Trial.","authors":"Damla Karabay, Sevgi Sevi Yeşilyaprak, Mehmet Erduran, Cem Ozcan","doi":"10.1177/19417381241236817","DOIUrl":"10.1177/19417381241236817","url":null,"abstract":"<p><strong>Background: </strong>Subacromial pain syndrome (SPS) is the most common cause of shoulder pain. Therapeutic exercise is the first-line treatment for SPS; however, the ideal exercise type remains unclear. Here, we compared the effects of eccentric and concentric strengthening in patients with SPS.</p><p><strong>Hypothesis: </strong>Adding isolated eccentric strengthening to a multimodal physiotherapy program (MPP) would lead to greater improvements in outcomes compared with either MPP alone or adding isolated concentric strengthening to the MPP.</p><p><strong>Study design: </strong>Randomized controlled trial.</p><p><strong>Level of evidence: </strong>Level 2.</p><p><strong>Methods: </strong>A total of 45 patients were randomized to eccentric strengthening (ESG), concentric strengthening (CSG), and control (CG) groups; all groups received the MPP. The strengthening groups also performed group-specific strengthening. Shoulder pain, abduction and external rotation (ER) strength, joint position sense (JPS), the Constant-Murley Score (CMS), and the Disabilities of the Arm, Shoulder and Hand score were collected at baseline, after 12 weeks of treatment, and at week 24.</p><p><strong>Results: </strong>For CMS, ESG exhibited a greater, but not clinically meaningful, improvement than CSG and CG (<i>P</i> < 0.05). Eccentric abduction strength increased in ESG compared with CG. From baseline to follow-up, abduction strength increased in ESG compared with CSG and CG. Eccentric abduction strength increased in CSG compared with CG. JPS at abduction improved in the ESG compared with CG. Other between-group comparisons were not significant (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>In SPS, eccentric strengthening provided added benefits, improving shoulder abduction strength and JPS at abduction, and was superior to concentric strengthening for improving shoulder abduction strength. Neither strengthening approach had an additional effect on shoulder function, pain, ER strength, or rotational JPS.</p><p><strong>Clinical relevance: </strong>Clinicians could implement eccentric strengthening as a motor control retraining for strength and proprioception gain rather than for pain relief and reducing disability.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"322-331"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does It Matter? Isometric or Isokinetic Assessment of Quadriceps Strength Symmetry 9 Months After ACLR in Collegiate Athletes.","authors":"Daniel G Cobian, Keith A Knurr, Mikel R Joachim, Amy L Bednarek, Andrew M Broderick, Bryan C Heiderscheit","doi":"10.1177/19417381241247819","DOIUrl":"10.1177/19417381241247819","url":null,"abstract":"<p><strong>Background: </strong>Greater quadriceps strength symmetry is associated with better outcomes after anterior cruciate ligament reconstruction (ACLR). Isometric and isokinetic assessments of quadriceps strength inform therapeutic exercise prescription and return-to-sport decisions. It is unclear whether isometric and isokinetic measures provide similar information post-ACLR.</p><p><strong>Hypothesis: </strong>Quadriceps strength symmetry is similar between isometric and isokinetic assessments. Isokinetic and isometric strength symmetries have similar associations to functional knee kinetics and self-reported knee function.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>NCAA Division I athletes (N = 35), 8.9 ± 2.5 months post-ACLR completed isometric and isokinetic quadriceps strength assessments, countermovement jumps (CMJs), and treadmill running. Self-reported knee function was assessed using the International Knee Documentation Committee Subjective Knee Form (IKDC). Agreement between isometric and isokinetic strength symmetry was assessed using Bland-Altman analysis, with associations to functional knee kinetics and IKDC assessed using Pearson correlations and linear regressions.</p><p><strong>Results: </strong>Mean difference in quadriceps strength symmetry between isokinetic and isometric assessments was 1.0% (95% limits of agreement of -25.1% to 23.0%). Functional knee kinetics during running and CMJ were moderately to strongly associated with isometric strength symmetry (<i>r</i> = 0.64-0.80, <i>P</i> < 0.01) and moderately associated with isokinetic strength symmetry (<i>r</i> = 0.41-0.58, <i>P</i> < 0.01). IKDC scores were weakly to moderately associated with isometric (<i>r</i> = 0.39, <i>P</i> = 0.02) and isokinetic (<i>r</i> = 0.49, <i>P</i> < 0.01) strength symmetry.</p><p><strong>Conclusion: </strong>Isokinetic and isometric assessments of quadriceps strength symmetry in collegiate athletes 9 months post-ACLR demonstrated strong agreement. Quadriceps strength symmetry is associated with functional knee kinetic symmetry post-ACLR.</p><p><strong>Clinical relevance: </strong>Considerable individual variation suggests mode of contraction should be consistent throughout postoperative assessment. Isometric strength symmetry may be a better indicator of functional knee kinetic symmetry, while isokinetic strength symmetry may be associated more closely with patient-reported outcomes.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"365-373"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}